A philosophical analysis of the concept 'advocacy' : implications for professional-patient relationships

This project provides an analysis of the concept 'advocacy'. It uncovers assumptions regarding the meanings of advocacy as this concept has been utilized in health care settings to describe professional actions of various sorts. The primary objective of the undertaking is to facilitate the goals of medicine, nursing, and other health care professions in regard to the population of their concern. To the extent the goals of medicine and nursing are focused on promoting the well-being of persons and society the pursuit of such goals is a moral endeavor. The analysis provides for consistency of communication among the professions with regard to advocacy and exposes the scope of professional obligation for health care professionals. Chapter One outlines problems surrounding uses of the term 'advocacy.' It offers an explication of other concepts which prove important for the analysis such as 'profession', 'physician-patient relationship', 'nurse-patient relationship', and 'clinical ethics'. Chapter Two makes some distinctions regarding advocacy and considers the context in which professions provide service to society. Additionally, the 'ideal' of lawyers as exemplars of professional advocacy is explored since it is from this setting notions of 'advocacy' for health care professions have been borrowed. In Chapter Three an investigation of the nature and foundations of professional obligations is undertaken. Codes of ethics are discovered to be important sources of a profession's own view of its obligations; these allow assessment of a professional's moral accountability. As the investigation develops, professional advocacy is seen to be a complex role-responsibility. The focus of Chapter Four is a discussion of the proposal that professional advocacy is a broader concept for health care professionals than it is for legal advocates because it involves both attention to individual needs and attention to the needs of society. Thus the source of some interdisciplinary confusions is located. Finally, Chapter Five elucidates the implications of the newly clarified concept 'Professional Advocacy' when this is applied to health care situations as an account of health care professional obligation to both individuals and society.